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The Health portfolio covers a range of policy and program areas aimed at achieving better health and ageing outcomes for Australians; supporting equitable, efficient and high-quality health and aged care systems; and improving opportunities for better outcomes in sport.
Read an overview of the Health portfolio including details of key activities, expenses and staffing levels. The audit focus section outlines the influences on the ANAO’s allocation of financial audit resources and the selection of performance audit topics and other activities. Also included is a list of material and non-material entities within the portfolio with their corresponding risk profile and key risks. Any risks that are considered key audit matters (KAMs) by the ANAO are separately identified.
This audit would examine the Department of Health’s implementation of the My Aged Care portal, including the extent to which it has facilitated greater access for older Australians and their families to information and support services.
The My Aged Care portal, which was introduced in July 2013, comprises a website and a call centre and serves as the primary contact point for people seeking information on subsidised aged care. On 1 July 2015, the My Aged Care portal was expanded to become the single entry point to the aged care system in Australia.
The Department of Health reported in its annual report that 2015–16 had been a transitional year for the sector, and identified the initial challenges of stabilising the technology platform, and the need for the contact centre, assessors and providers to adapt to new processes.
The audit would assess the effectiveness of the Department of Health’s health professionals compliance arrangements.
The Department of Health undertakes compliance activities to reduce fraud, inappropriate practice and incorrect claiming of payments by providers under the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme, the Child Dental Benefits Schedule, and various incentives programs to improve the health status of Australians living in regional, rural and remote communities.
In 2017–18, the department’s budget for health benefit compliance was $81 million, with performance targets of $15.6 million of debt recovered and $13 million in savings due to positive behavioural change from activities in previous years.
An assurance review would examine whether the Department of Health has obtained assurance that the financial benefits from the Prostheses List reforms accruing to private health insurers have been passed on to consumers in the form of premium reductions.
The Prostheses List legislates the minimum benefits payable by private insurers (if insurance is held by the patient) for specific prostheses. As of 1 February 2018, the minimum benefit payable by private health insurers was reduced. In return for the reduction in payment obligations, private health insurers advised that every $200 million in prostheses benefits reductions will decrease private health insurance premiums by one per cent.
Private health insurers submit applications to the Minister for Health for premium increases at the same time each year. Each application is examined by the Department of Health and the Australian Prudential Regulation Authority. This process is known as the annual premium round. Premium changes take effect from 1 April each year.